Tunable interaction between metal clusters and graphene.

We describe the interaction between small transition metal clusters and graphene using first principles calculations. The coupling is analyzed in terms of different features of the system: binding energy, decomposition into atomic orbitals, the presence of defects on the graphene layer, and both the band and geometrical structures. The binding strength is found to follow the d-band model, which anticipates the binding energies of clusters on graphene layers from the position of the cluster's d-band centers relative to the their highest-occupied and lowest-unoccupied molecular orbital levels. These findings are verified for 6-atom and 13-atom transition metal clusters (Ti, Pd, Pt, and Au) and considering different types of defects. The adhesion of the TM clusters is substantially larger on defective graphene layers than on pristine ones. Buckling of the graphene layer may arise from the presence of defects but it does not necessarily imply strong binding. However, buckling can sometimes offer configurational paths through which the adsorbed cluster is stabilized changing its original shape. Insights into this work offer mechanisms to tailor the electronic properties of the combined nanoparticle-graphene system by changing the size and composition of transition metal clusters.

Patient and Practice Characteristics: Impact on Career Satisfaction of Obstetrician-Gynecologists.

This study examined demographic and practice characteristics that affect the career satisfaction of obstetrician-gynecologists. Data were retrieved from the 2008 Health Tracking Physician Survey, conducted by the Center for Studying Health System Change. The survey consisted of a nationally representative sample of physicians belonging to the American Medical Association. A final sample of 290 obstetrician-gynecologists was obtained from the study. Results indicated more than 80% of obstetrician-gynecologists were either "somewhat satisfied" or "very satisfied" with their careers in medicine. Nearly 56% were older than 48 years; 59% of respondents were men and 77% were of white race. The average obstetrician-gynecologist worked 54 hours per week in medically related activities. Regression analysis showed a significant relationship between obstetrician-gynecologist career satisfaction and the following: adequate time with patients, perceived quality of care, income, work hours, and revenue from Medicaid. In addition, Hispanic patients and the presence of formal written guidelines had a positive impact on career satisfaction. It was concluded that quality care, time with patients, work hours, and income are the major predictors of obstetrician-gynecologist career satisfaction. Further research is needed to understand the relationship between patient demographics and career satisfaction.

Dimensions of quality care affecting career satisfaction of pediatricians.

This study investigated factors impacting career satisfaction among pediatricians. The study used data from the 2008 Health Tracking Physician Survey, conducted by the Center for Studying Health System Change. The 2008 Health Tracking Physician Survey data set consisted of 4720 physicians who were members of the American Medical Association. Among the respondents, 427 identified themselves as pediatricians. Results indicated more than 52% of pediatricians were very satisfied with their careers in medicine. Nearly 35% of pediatricians were older than 48 years. Approximately 48% were male, and 67% were of white race. The average respondent worked 45 hours per week in medically related activities. Regression analysis indicated the following had a significant impact on pediatrician career satisfaction: inadequate time with patients, patient noncompliance, and delayed reports from other physicians and facilities. Number of hours worked per week and worry over potential malpractice suits also had a significant impact on career satisfaction of pediatricians.

Mobile Medication Adherence Platform for Buprenorphine (MAP4BUP): A Phase I feasibility, usability and efficacy pilot randomized clinical trial.

BACKGROUND/AIM: Poor medication adherence is one of the main barriers to the long-term efficacy of buprenorphine/naloxone (BUP/NAL). The aims of this pilot investigation were to examine if a Bluetooth-enabled pill cap and mobile application is a feasible, usable tool for increasing BUP/NAL adherence among people with an opioid use disorder. METHODS: This pilot randomized clinical trial (RCT; total n = 41) lasted 12 weeks and was conducted in two office-based BUP/NAL provider locations in Spokane, WA and Coeur d'Alene, ID from January 2020 to September of 2021 with an 11-month gap due to COVID-19. Patients receiving BUP/NAL who consented to participate were randomized to receive the pill cap device (PLY group; n = 19) or a service as usual (SAU group; n = 22) group that included an identical but inactive cap for their bottle. The PLY group received reminders via text and voice, and the support of a "helper" (e.g., friend) to monitor pill cap openings. RESULTS: Most participants in PLY group found the device both feasible (92.86 %) and usable (78.57 %). Most participants liked using the device (92.86 %) and were satisfied with the device (85.71 %). While not statistically different from one another, medication adherence per the Medication Possession Ratio was 75 % in the SAU group and 84 % in the PLY group. Pill cap openings were significantly higher in the PLY group with an average of 91.8 openings versus the SAU group's average of 56.7 (p < 0.05). CONCLUSION: The devices was feasible, usable, and patients had high levels of satisfaction. The device was associated with increased pill openings.

Conference report: WHO meeting summary on mRNA-based tuberculosis vaccine development.

Tuberculosis (TB) is a global health emergency. Across the globe, approximately 2 billion people are currently infected with Mycobacterium tuberculosis (Mtb), and of those, 5-10% may progress to become ill and potentially transmit the bacterium. In 2021, nearly 10.6 million people developed TB disease and 1.6 million died. There is an urgent need for accelerated development of new TB-focused interventions, in particular, improved TB vaccines. However, progress in developing highly effective TB vaccines has been slow and is chronically under-resourced. The mRNA vaccine platform may offer an opportunity to accelerate development of new TB vaccines. In April 2023, the World Health Organization convened global experts to discuss the feasibility and potential value of mRNA-based vaccines for TB. Here we report on meeting deliberations related to the current TB vaccine pipeline and potential novel antigens, the status of efforts to identify correlates of protection, potential clinical development strategies and considerations for community acceptance of new TB vaccines based on this relatively new platform. The role of industry collaborations, ethics, social science, and responsibility to the global community regarding transparency and manufacturing capacity building were discussed through expert presentations and panel sessions. The overall conclusion of the meeting is that mRNA-based vaccines constitute a potentially powerful new tool for reducing the global burden of TB.

The effect of patient satisfaction scores on physician job satisfaction and burnout.

Physician burnout is recognized as reversible with the potential to negatively influence quality of care and patient outcomes. The study objective was to evaluate associations between patient satisfaction scores (PSS) and physicians' perceptions of job satisfaction and burnout via a physician survey. Eighty two out of 107 report PSS are institutionally tracked, with 23/107 and 39/107 reporting PSS utilization in financial compensation or performance review, respectively. Fifty four out of 107, report pressure to emphasize PSS; 63/107, report PSS having negative effect on job satisfaction; 31/107 considered leaving their job or career due to PSS and 84/107 report PSS contribute to burnout. In the cohort of physicians treating patients with spine pain who responded to this survey, PSS are associated with decreased job satisfaction and increased burnout.

Bacterial communities in Malagasy soils with differing levels of disturbance affecting botanical diversity.

Madagascar is well-known for the exceptional biodiversity of its macro-flora and fauna, but the biodiversity of Malagasy microbial communities remains relatively unexplored. Understanding patterns of bacterial diversity in soil and their correlations with above-ground botanical diversity could influence conservation planning as well as sampling strategies to maximize access to bacterially derived natural products. We present the first detailed description of Malagasy soil bacterial communities from a targeted 16S rRNA gene survey of greater than 290,000 sequences generated using 454 pyrosequencing. Two sampling plots in each of three forest conservation areas were established to represent different levels of disturbance resulting from human impact through agriculture and selective exploitation of trees, as well as from natural impacts of cyclones. In parallel, we performed an in-depth characterization of the total vascular plant morphospecies richness within each plot. The plots representing different levels of disturbance within each forest did not differ significantly in bacterial diversity or richness. Changes in bacterial community composition were largest between forests rather than between different levels of impact within a forest. The largest difference in bacterial community composition with disturbance was observed at the Vohibe forest conservation area, and this difference was correlated with changes in both vascular plant richness and soil pH. These results provide the first survey of Malagasy soil bacterial diversity and establish a baseline of botanical diversity within important conservation areas.

In silico analysis of accurate proteomics, complemented by selective isolation of peptides.

Protein identification by mass spectrometry is mainly based on MS/MS spectra and the accuracy of molecular mass determination. However, the high complexity and dynamic ranges for any species of proteomic samples, surpass the separation capacity and detection power of the most advanced multidimensional liquid chromatographs and mass spectrometers. Only a tiny portion of signals is selected for MS/MS experiments and a still considerable number of them do not provide reliable peptide identification. In this article, an in silico analysis for a novel methodology of peptides and proteins identification is described. The approach is based on mass accuracy, isoelectric point (pI), retention time (t(R)) and N-terminal amino acid determination as protein identification criteria regardless of high quality MS/MS spectra. When the methodology was combined with the selective isolation methods, the number of unique peptides and identified proteins increases. Finally, to demonstrate the feasibility of the methodology, an OFFGEL-LC-MS/MS experiment was also implemented. We compared the more reliable peptide identified with MS/MS information, and peptide identified with three experimental features (pI, t(R), molecular mass). Also, two theoretical assumptions from MS/MS identification (selective isolation of peptides and N-terminal amino acid) were analyzed. Our results show that using the information provided by these features and selective isolation methods we could found the 93% of the high confidence protein identified by MS/MS with false-positive rate lower than 5%.